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CCG Outcomes Indicator Set 2013/2014

The Clinical Commissioning Group Outcomes Indicator Set (CCGOIS) (formerly known as the ‘Commissioning Outcomes Framework’ [COF]) forms an integral part of NHS England’s approach to quality improvement in healthcare.

The aim of the CCGOIS is to support clinical commissioning groups (CCGs) to plan for health improvement by providing information for measuring and benchmarking outcomes of services commissioned by them. It also provides clear information for patients and the public about the quality of health services commissioned by CCGs and the associated health outcomes, and acts as a yardstick against which CCGs are judged for their contribution towards improving patient outcomes and the quality of commissioning. The indicators became active in April 2013 following consultation with NICE.

The CCGOIS has been selected on the basis that all the indicators contribute to the five domains of the NHS Outcomes Framework (see below).

NHS Outcomes Framework ‘five domains’
Domain 1—preventing people from dying prematurely Domain 2—enhancing quality of life for people with long-term conditions Domain 3—helping people to recover from episodes of ill health, or following injury Domain 4—ensuring that people have a positive experience of care Domain 5—treating and caring for people in a safe environment; and protecting them from avoidable harm.

1: Preventing people from dying prematurely

OVERARCHING INDICATOR

Potential years of life lost from causes considered amenable to healthcare: adults, children and young people (NHS OF 1a i & ii) *

IMPROVEMENT AREAS

Reducing premature mortality from the major causes of death Under 75 mortality from cardiovascular disease (NHS OF 1.1) * † Cardiac rehabilitation completion Myocardial infarction, stroke and stage 5 kidney disease in people with diabetes Mortality within 30 days of hospital admission for stroke Under 75 mortality from respiratory disease (NHS OF 1.2) * † Under 75 mortality from liver disease (NHS OF 1.3) * Emergency admissions for alcohol-related liver disease Under 75 mortality from cancer (NHS OF 1.4) * † One- and five-year survival from all cancers (NHS OF 1.4.i and ii) * One- and five-year survival from breast, lung, and colorectal cancers (NHS OF 1.4 iii and iv) *

Reducing premature death in people with serious mental illness People with severe mental illness who have received a list of physical checks

Reducing deaths in babies and young children Antenatal assessment <13 weeks Maternal smoking at delivery Breastfeeding prevalence at 6–8 weeks

Reducing premature deaths in people with learning disabilities NHS OF indicator in development. No CCG measure at present

2: Enhancing quality of life for people with long-term conditions

OVERARCHING INDICATOR

Health-related quality of life for people with long-term conditions (NHS OF 2) * ‡

IMPROVEMENT AREAS

Ensuring people feel supported to manage their condition People feeling supported to manage their condition (NHS OF 2.1) * † ‡

Improving functional ability in people with long-term conditions People with COPD and Medical Research Council Dy spnoea scale ≤3 referred to a pulmonary rehabilitation programme People with diabetes who have received nine care processes People with diabetes diagnosed less than 1 year referred to structured education

Reducing time spent in hospital by people with long-term conditions Unplanned hospitalisation for chronic ambulatory care sensitive conditions (adults) (NHS OF 2.3.i) * Unplanned hospitalisation for asthma, diabetes, and epilepsy in under 19s (NHS OF 2.3.ii) * Complications associated with diabetes including emergency admission for diabetic ketoacidosis and lower limb amputation

Enhancing quality of life for carers No CCG measure at present

Enhancing quality of life for people with mental illness Access to community mental health services by people from BME groups Access to psychological therapy services by people from BME groups Recovery following talking therapies (all ages and older than 65)

Enhancing quality of life for people with dementia Estimated diagnosis rate for people with dementia (NHS OF 2.6i) People with dementia prescribed anti-psychotic medication

3: Helping people to recover from episodes of ill health or following injury

OVERARCHING INDICATOR

Emergency admissions for acute conditions that should not usually require hospital admission (NHS OF 3a) * Emergency readmissions within 30 days of discharge from hospital (NHS OF 3b) †

IMPROVEMENT AREAS

Improving outcomes from planned treatments Increased health gain as assessed by patients for elective procedures: hip replacement knee replacement groin hernia varicose veins (NHS OF 3.1 i–iv)

Preventing lower respiratory tract infections in children from becoming serious Emergency admissions for children with lower respiratory tract infections (NHS OF 3.2) *

Improving recovery from injuries and trauma NHS OF indicator in development. No CCG measure at present

Improving recovery from stroke People who have had a stroke who are admitted to an acute stroke unit within 4 hours of arrival to hospital receive thrombolysis following an acute stroke are discharged from hospital with a joint health and social care plan receive a follow-up assessment between 4–8 months after initial admission

Improving recovery from fragility fractures No CCG measure at present

Helping older people to recover their independence after illness or injury No CCG measure at present

4: Ensuring that people have a positive experience of care

OVERARCHING INDICATOR

Patient experience of primary and hospital care Patient experience of GP out of hours services (NHS OF 4a ii) * Patient experience of hospital care (NHS OF 4b) Friends and family test for acute inpatient care and A&E (NHS OF 4c)

IMPROVEMENT AREAS

Improving people’s experience of outpatient care Patient experience of outpatient services (NHS OF 4.1)

Improving hospitals’ responsiveness to personal needs Responsiveness to in-patients’ personal needs (NHS OF 4.2)

Improving people’s experience of accident and emergency services Patient experience of A&E services (NHS OF 4.3)

Improving women and their families’ experience of maternity services Women’s experience of maternity services (NHS OF 4.5)

Improving the experience of care for people at the end of their lives No CCG measure at present

Improving experience of healthcare for people with mental illness Patient experience of community mental health services (NHS OF 4.7)

Improving children and young people’s experience of healthcare NHS OF indicator in development. No CCG measure at present

Improving people’s experience of integrated care NHS OF indicator in development. No CCG measure at present

5: Treating and caring for people in a safe environment and protecting them from avoidable harm

OVERARCHING INDICATOR

Patient safety incidents reported (NHS OF 5a)

IMPROVEMENT AREAS

Reducing the incidence of avoidable harm Incidence of venous thromboembolism (VTE) (NHS OF 5.1) Incidence of healthcare associated infection: MRSA (NHS OF 5.2.i) Incidence of healthcare associated infection: C. difficile (NHS OF 5.2.ii) No CCG measures at present for category 2, 3, and 4 pressure ulcers and incidence of medication errors causing serious harm

Improving the safety of maternity services No CCG measure at present

Delivering safe care to children in acute settings No CCG measure at present